Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA.
Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA.
Int J Environ Res Public Health. 2020 Nov 20;17(22):8619. doi: 10.3390/ijerph17228619.
Asthma affects millions of people globally and is especially concerning in populations living with poor air quality. This study examines the association of ambient outdoor air pollutants on asthma-related emergency department (ED) visits in children and adults throughout the Pittsburgh region. A time-stratified case-crossover design is used to analyze the lagged effects of fine particulate matter (PM) and gaseous pollutants, e.g., ozone (O), sulfur dioxide (SO), nitrogen dioxide (NO), and carbon monoxide (CO) on asthma-related ED visits ( = 6682). Single-, double-, and multi-pollutant models are adjusted for temperature and analyzed using conditional logistic regression. In children, all models show an association between O and increased ED visits at lag day 1 (OR: 1.12, 95% CI, 1.03-1.22, < 0.05) for the double-pollutant model (OR: 1.10, 95% CI: 1.01-1.20, < 0.01). In adults, the single-pollutant model shows associations between CO and increased ED visits at lag day 5 (OR: 1.13, 95% CI, 1.00-1.28, < 0.05) and average lag days 0-5 (OR: 1.22, 95% CI: 1.00-1.49, < 0.05), and for NO at lag day 5 (OR: 1.04, 95% CI: 1.00-1.07, < 0.05). These results show an association between air pollution and asthma morbidity in the Pittsburgh region and underscore the need for mitigation efforts to improve public health outcomes.
哮喘影响着全球数百万人,尤其在空气质量较差的人群中更为严重。本研究调查了匹兹堡地区室外空气污染物对儿童和成人哮喘相关急诊就诊的影响。采用时间分层病例交叉设计分析细颗粒物(PM)和气态污染物(如臭氧(O)、二氧化硫(SO)、二氧化氮(NO)和一氧化碳(CO))滞后效应对哮喘相关急诊就诊的影响(n=6682)。单污染物、双污染物和多污染物模型均进行了温度调整,并采用条件逻辑回归进行分析。在儿童中,所有模型均显示 O 与滞后 1 天的急诊就诊增加之间存在关联(双污染物模型 OR:1.12,95%CI:1.03-1.22,<0.05)(双污染物模型 OR:1.10,95%CI:1.01-1.20,<0.01)。在成人中,单污染物模型显示 CO 与滞后 5 天的急诊就诊增加之间存在关联(OR:1.13,95%CI:1.00-1.28,<0.05)和滞后 0-5 天的平均天数(OR:1.22,95%CI:1.00-1.49,<0.05),NO 在滞后 5 天也存在关联(OR:1.04,95%CI:1.00-1.07,<0.05)。这些结果表明,匹兹堡地区的空气污染与哮喘发病率之间存在关联,这凸显了需要采取缓解措施来改善公共卫生结果。